Cancer and Medical Cannabis/Medical Marijuana

Cancer and Medical Marijuana

Definition

The classic biological definition of cancer is “unregulated cellular proliferation”. The mechanisms that allow unregulated proliferation of cancerous cells is a realignment of cellular circuitry for growth cues.

Potential Efficacy / Quality of Evidence (Low, Average, High) of Medical Marijuana for Cancer

High, although this depends on the type of cancer.

The cannabinoid profile of the cannabis product being used must match the cancer classification. Not all cancers are responsive to cannabinoids and, due to the effects of cannabinoids on the immune system, can potentially make cancer treatments that affect the immune system – such as chemotherapy or immunotherapy – dangerous. Using the wrong cannabinoid profile may also potentially cause some tumours/cancers to grow. Therefore, it is of utmost importance that cancer patients find the right cannabinoid-terpenoid profile for them and the particular kind (classification) of cancer.

Cannabinoids, Terpenes/Terpenoids, Strains and Ratios that May Help

It is arguable that all the cannabinoids and terpenes in cannabis could be helpful for cancer. However, some cancers may need specific profiles and dosages, for example some types of breast cancer.

Effective ratio depends very much upon the cancer, but a wide range of cannabinoids is ideal as many have anti-cancer properties and work best in conjunction with one another. High THC may be needed, but not in all instances.

Medical Cannabis Pros

Cannabis can help treat the side-effects of chemotherapy. The prescription drugs, Marinol and Dronabinol, are synthetic versions of THC designed with this purpose in mind. However, synthetic THC can be much stronger than the THC derived from cannabis, and there aren’t any other cannabinoids balancing out the synthetic THC and improving its efficacy via the entourage effect. Many people find natural THC to be much more tolerable.

Helps cancer patients treat pain, inflammation, nausea, improper sleep and cachexia (wasting syndrome).

Cannabis could kill cancer cells or tell them to slow down – cannabis could have significant antitumor properties.

There are some who suggest that significant inflammation from an event in the past or from the diet may trigger cancer – cannabinoids may help prevent this inflammation, as many of them are potent anti-inflammatories.

Terpenes like beta-caryophyllene (which is a cannabinoid as well), pinene and humulene have significant antibacterial and anti-tumoral properties as well, and may also increase the efficacy of some chemotherapy drugs (e.g. paclitaxel).

Medical Cannabis Cons

Though there is no proven link between smoking cannabis alone and lung cancer, it makes sense to perhaps avoid combusting any plant material and breathing the resulting smoke into your lungs. This is especially the case if you suffer from lung cancer and/or breathing problems

Those undergoing immunotherapy for cancer may way to avoid cannabinoid treatment, due to cannabinoids’ effect on the immune system.

One of the side-effects of chemotherapy is a suppressed immune system. Therefore, it is of utmost importance that your medication is as pathogen-free as possible.

The cannabinoid profile, ratio and dosage must match the cancer classification. If it does not match, cannabinoid treatment may be ineffective or even harmful.

More About the Condition

Cannabis seems to work for so many cancer patients because it not only helps manage the side-effects of chemotherapy, but may also help battle cancer of many types. Bladder, brain, breast, colon, endocrine, kaposi sarcoma, leukemia, lung, prostate and skin cancers have the potential to be beaten by cannabis. The following studies also show some promise with regards to treating cancer with cannabinoids

Cannabidiol (CBD) as potential anticancer drug

Cannabinoids – a new weapon against cancer?

GW Pharmaceuticals Achieves Positive Results in Phase 2 Proof of Concept Study in Glioma

Cannabinoids as therapeutic agents in cancer: current status and future implications

We also highly recommend reading the works of Dr. Cristina Sanchez who, alongside Dr. Manuel Guzman, has looked at the possibility of using cannabis for even the most aggressive of cancers. Their results are on the most part highly promising. Though there is much research that needs to be done to discover how effective cannabis is for various kinds of cancer, there is significant anecdotal and lab data that suggests we should definitely explore further.

In order to understand why cannabis may help for cancer, it is helpful to understand a little bit more about how cancers are formed and developed. To answer this question, Dr. Michael Masterman-Smith probably has the most straightforward explanation:

“In order to answer this we have to look at some basic tenets of cancer biology and how cancer cells mutate to stay alive and proliferate as cancer cells. If we look at the classic biological definition of cancer, it is ‘unregulated cellular proliferation’. The mechanisms that allow unregulated proliferation is a realignment of cellular circuitry to for growth cues.

The genetic machinery is essentially altered to overproduce cell surface receptors, called growth factor receptors (GFRs). These are antennas which amplify and activate chemical signals that run along complex molecular pathways in the cancer cell to drive cancer cell growth and proliferation. Many cancer drugs we use today target these signalling pathways.

There is some evidence to show that cannabinoid receptors are expressed on cancer cells. This supports the pharmacological basis for why cannabinoid receptor agonists (i.e. cannabinoids) could be effective for cancer. A cancer cell is trying to figure out ways to grow so it puts its receptors on the cell, one of which happens to be cannabinoid receptors. The pharmacological action of a cannabinoid receptor agonist depends on the cell type. In cancer cells it may be like and act as a trojan horse.

Current understanding appears that cannabinoids goes through these receptors and activates the production of a compound called ceramide which regulates the differentiation, proliferation and death of cells. In cancer cells, and perhaps cancer stem cells, this effect is widestream system outage, shutting down cancerous signalling pathways, several of which are major targets in cancer drug development and, often difficult to target pathways, I might add.

This is the emerging understanding of the relationship between cancer cells, cannabinoids and cannabinoid receptor agonists that can advance new ways to understand and treat cancer.”

So, basically, cannabis can help beat cancer, as different types of cancer (but not all types of cancer) have endocannabinoid receptors. Phytocannabinoids can be used to influence these receptors, and give cancer cells the instructions to slow down growth or even kill itself.

There is little evidence that cannabis alone can help beat different types of cancer.

Chemotherapy and radiation therapy are often still needed. Another thing to realise is that not all types of cancer have endocannabinoid receptors, so cannabis may be ineffective. Moreover, for some kinds of cancer, the correct cannabinoid ratio must be used, as the wrong one may either do nothing or even tell the cancer to grow ! As cannabinoids can help dampen the immune system, and chemo- and radiotherapy also dampen the immune system, care must be taken lest an infection cause further complications or even death.

When it comes to appropriate treatment, should one use as many cannabinoids and terpenes as possible in as high doses as possible and utilize the entourage effect as much as possible (often used in the Rick Simpson method), or should specific profiles be used to beat specific cancers in as clinical a way as possible? Or perhaps we do need to use a specific cannabinoid-terpenoid ratio, and then flood the body so as to ensure the cannabinoids reach all cells in the body? Synthetic cannabinoids, in spite of their potential dangers, may also allow for an even greater degree of targeted cancer therapy. Until more research is done, we do not have any definite answers.

Quotes from Experts

Antitumor Effect of Cannabinoid – Based Therapies Related to Subtypes of Breast Cancer

“Cannabinoid receptors have been identified in pancreatic cancer with several studies showing in vitro antiproliferative and proapoptotic effects. The main active substances found in cannabis plants are cannabidiol (CBD) and tetrahydrocannabinol (THC). There effects are predominantly mediated through, but not limited to cannabinoid receptor-1, cannabinoid receptor-2, and G-protein-coupled receptor 55 pathways. In vitro studies consistently demonstrated tumor growth-inhibiting effects with CBD, THC, and synthetic derivatives. Synergistic treatment effects have been shown in two studies with the combination of CBD/synthetic cannabinoid receptor ligands and chemotherapy in xenograft and genetically modified spontaneous pancreatic cancer models. There are, however, no clinical studies to date showing treatment benefits in patients with pancreatic cancer.” Source: Sharafi, Golnaz et al. ‘Potential Use of Cannabinoids for the Treatment of Pancreatic Cancer‘ Journal of pancreatic cancer vol. 5,1 1-7. 25 Jan. 2019, doi:10.1089/pancan.2018.0019